2.1 How can EU procurement legislation contribute to quality long-term care ?

EU Directive 2014/24/EU of 26 February 2014

on procurement regulates the leeway of Member States to define what they consider to be services of general economic interest and how those services should be organised and financed (Article 1.4 of the Directive). This means that governments have the choice on whether or not social services shall be procured from third parties or be provided by the state. Governments may also declare specific social services as ‘non-economic services of general interest’ and thus exclude them from the scope of the Directive.

If public authorities decide to organise social services as ‘services of general economic interest’, these need to be procured through public contracts.1 This means that public authorities create a context which gives preference to ‘buying’ rather than ‘making’ LTC services (Rodrigues et al., 2013). We will examine here how the ensuing process of specifying, securing and monitoring services, also called commissioning, can be used to ensure quality in the delivery of LTC services in Europe. This process involves a broad range of activities ranging from social planning (individual, community and general needs assessment) to the authorisation, accreditation and contracting of (new) providers as well as quality monitoring and assurance.

1 There is an ongoing evaluation of state subsidy rules for health and social services of general economic interest with very weak participation of stakeholders; a final report is being envisaged for 2021 (https://ec.europa.eu/info/law/better-regulation/have-your-say/initiatives/11835-Evaluation-of-State-aid-rules-for-health-andsocial-services-of-general-economic-interest-and-SGEI-De-Minimis). Article 1.4 reiterates that Member States have the freedom to define, in compliance with EU law, what they consider to be services of general economic interest and how those services should be organised and financed.

Only if and when contracting authorities choose to procure social and health services (listed in Annex XIV), and if the amount of the contract is equal or above €750,000, Member States must apply the rules set out in articles 74-77 of the Directive referring to social and other specific services.

Articles 74-77 specify the publication of notices, the scope of reserved contracts and the principles of awarding contracts, namely:

• quality, • continuity, • accessibility, • affordability, • availability, • comprehensiveness of services, • the specific needs of different categories of users, including disadvantaged and vulnerable groups, • innovation, • the involvement and empowerment of users.

Article 76.2 also specifies: “Member States may also provide that the choice of the service provider shall be made on the basis of the tender presenting the best price-quality ratio, taking into account quality and sustainability criteria for social services”.